Categorical Eligibility for Special Education: The Enshrinement
of the Medical Model in Disability Policy

Sarah L. Triano
University of Illinois at Chicago

Abstract

To qualify for the right to a free and appropriate public education,
disabled students in most states must meet the categorical eligibility
requirements outlined in Section 300.7 of IDEA. The fundamental question
posed in this article is: do students with disabilities really have
a right to equal educational opportunity when that right is tied to
a stigmatizing label based on a medical model of disability? This article
attempts to answer that question through an analysis of (a) the history
of categorical eligibility for special education (b) its purpose and
(c) its problems. It then examines some of the changes that have been
proposed to current eligibility policies and practices. The article
concludes with a rejection of both categorical and non-categorical eligibility
and calls for a fundamental restructuring of the educational system
and a reconceptualization of the right to equal educational opportunity
for students with disabilities.

On December 2, 1975, President Gerald Ford signed into law Public Law
(P.L.) 94-142, the Education for All Handicapped Children Act, which guaranteed
the right to a free and appropriate public education for the nation's
8 million children with disabilities. Prior to the passage of this Act,
disabled children were routinely excluded from the public school system
on the basis of their disability (Zettel, 1977). A 1919 Wisconsin Supreme
Court ruling, in fact, held that "a mentally normal, blind child
could be barred from school since his/her handicap had a depressing and
nauseating effect on teachers and children" (Hensley, 1973). With
the passage of P.L. 94-142, this type of discrimination and exclusion
was declared unconstitutional and the Federal government took direct responsibility
for ensuring that all children with disabilities were afforded their right
to equal educational opportunity. In spite of this sweeping civil rights
mandate, however, in his statement on the signing of P.L. 94-142, President
Ford expressed several concerns regarding the Act's overall effectiveness:

I have approved S. 6, the Education for All Handicapped Children Act
of 1975. Unfortunately, this bill promises more than the Federal Government
can deliver, and its good intentions could be thwarted by the many unwise
provisions it contains. Everyone can agree with the objective stated
in the title of this bill - educating all handicapped children in our
Nation. The key question is whether the bill will really accomplish
that objective. (Ford, 1975)

Twenty-four years after the enactment of P.L. 94-142, now renamed the
Individuals with Disabilities Education Act (IDEA), contrary to President
Ford's concerns, it appears as if the main objective of the Act has been
realized. As of 1984 the number of disabled children served by schools
increased by approximately 500,000 over the number served in 1976-1977
(Sixth Annual Report, 1984) and as of 1998 the number of school-age students
with disabilities increased at a higher rate than the general school enrollment
(To Assure the Free, 1998).

Based on these numbers, it seems clear that the legislative objective
of "educating all handicapped children in our Nation" has been
achieved. What is less clear, however, is the extent to which disabled
children have been negatively affected by the eligibility provisions designed
to implement this legislative objective. In order for children with disabilities
in most states to receive their "right" to a publicly funded
education appropriate to their needs, they first have to be "diagnosed"
as fitting into one of several predetermined medical categories. It also
has to be shown that their medical label, or impairment, is the "cause"
of their educational difficulties and that special education and related
services are the "cure." The harm in this arrangement is self-evident
when one considers the cost involved in attributing the problems experienced
by disabled children in the educational system to a fundamental part of
their identity - their disability.

Children with disabilities in the U.S. have a right to a free and appropriate
public education, but at what cost? Is the price of receiving that right
the acceptance of a stigmatizing label based on a medical model of disability?
As the 25th anniversary of this historic Act approaches, questions need
to be raised regarding the efficacy of a system that requires children
with disabilities to be branded with a medical label that is contrary
to their identity and culture in order to receive the educational services
they need. Have the "good intentions" of IDEA been "thwarted,"
as Ford claimed, "by the many unwise provisions it contains,"
such as a system of categorical eligibility? An in-depth examination of
the history of categorical eligibility for special education and its purpose
and problems will attempt to answer this question followed by an analysis
of proposed changes to current policy and practice in the area of eligibility
for special education.

History of Categorical Eligibility for Special Education

The medical classification of children with disabilities for educational
purposes has been the historical norm for centuries. According to Safford
and Safford (1996), the idea of public instruction for certain categories
of children with disabilities was developed in Pre-Revolutionary Paris.
In 1760, the Abbe Charles Michel de l'Epee established the first public
school for the deaf in Paris, the Institution Nationale des Sourds-Muets
(Safford et al. 1996). The concept of public education for the deaf was
soon extended to blind children by Valentin Hany with the creation of
the Institution Nationale des Jeunes Aveugles in 1784 (Safford et al.
1996). The model of providing segregated "education and training"
for deaf and blind students was applied to children in other disability
categories as well, including children with physical and developmental
disabilities and deaf children with mental retardation who were ineligible
for admission to the deaf residential schools (Safford et al. 1996). During
the 19th century, this trend caught on in the United States with the opening
of the Connecticut Asylum for the Education and Instruction of Deaf and
Dumb Persons in Hartford on April 15, 1816 ("Significant Dates,"
1999).

Medical Classification of Children with Disabilities in England

In 1851, the first English school for children with physical disabilities
was established in Marylebone and in 1893 the Elementary Education (Blind
and Deaf Children) Act was passed. This Act gave each local education
authority in England and Wales responsibility to educate blind and deaf
students (Safford et al. 1996). In 1899, the provisions of this Act were
extended to children in other medical categories with the passage of the
Elementary Education (Defective and Epileptic) Act.

In a 1911 essay entitled, "The Care of Invalid and Crippled Children
in School," Elmslie attempted to provide a categorical definition
of children with "physical defect" for the purposes of establishing
eligibility under the Elementary Education (Defective and Epileptic) Act:

The Elementary Education (Defective and Epileptic) Act of 1899 gave
permission for the establishment of special schools for the education
of "children who, by reason of physical defect, are incapable of
receiving proper benefit from the instruction in an ordinary public
elementary school." The question which at once presents itself
is: To what children should this be taken to refer? (Elmslie, 1911,
p. 6)

In answer to this question, Elmslie outlined a very broad definition
of "physical defect":

In the medical supervision of schools it is advisable to adopt a very
wide definition of the term "Physical Defect." It should be
made to include not only all deformities and diseases of the bones,
joints, and spine which obviously cripple the child, but also all general
defects of physique and chronic illnesses, anything which continuously
interferes either with attendance at school or with the ability of the
scholar to follow in full the ordinary school routine. (Elmslie, 1911,
p. 5)

Later in the essay, Elmslie provided a listing of eight categories of
children with disabilities who fit this broad definition of "physical
defect":

Cripples with active disease, cripples with fixed deformity, phthisical
[sic] children with active disease, phthisical [sic] children in the
convalescent or quite stage, chronic invalids from such conditions as
heart disease and recurrent chorea, delicate nervous children, severe
cases of malnutrition, and children with combined defects (e.g. crippled
and mentally defective). (Elmslie, 1911, p. 7)

In 1916, Newman also addressed the eligibility requirements for the Elementary
Education (Defective and Epileptic) Act in his article, "Education
and Care of the Crippled Child":

Every child must be examined medically prior to admission to a Special
School in order that the statutory certificate may be completed by a
qualified medical practitioner approved by the Board of Education stating
that the child is by reason of physical defect incapable of receiving
proper benefit from the instruction in an ordinary Public Elementary
School, but is not incapable by reason of such defect of receiving proper
benefit from instruction in a Special School. (Newman, 1916, p. 86)

To anyone familiar with current special education law in the United States,
the similarities between the eligibility requirements for the 1899 Elementary
Education (Defective and Epileptic) Act and IDEA are striking. The Elementary
Education Act called for the "establishment of special schools"
to educate "children who, by reason of physical defect, are incapable
of receiving proper benefit from the instruction in an ordinary public
elementary school." IDEA calls for the provision of "special
education and related services" for a "child with a disability"
(as defined by Section 300.7) "who, by reason thereof, needs special
education and related services."

Although IDEA does not specifically state that children with disabilities
are incapable of benefiting from regular education because of their disability
(as directly noted in the Elementary Education Act), the historical precedent
and underlying assumption in the phrase, "who, by reason thereof,
needs special education and related services," seems obvious. In
1978, in fact, Alabama special education policy defined children with
disabilities as

those [children] who have been certified by specialists as being unsuited
for enrollment in regular classes of the public schools or who are unable
to be educated or trained adequately in such regular programs, including
but not limited to the mild and moderately retarded; the speech impaired;
the crippled and those having other physical handicaps not otherwise
specifically mentioned herein; the emotionally conflicted; the socially
maladjusted; those with special learning disabilities; the multiply
handicapped; and the intellectually gifted" (Newkirk et al., 1978).

The fact that IDEA's eligibility requirements are very similar to those
found in a law established in the 19th century that is based on a medical
model of disability is worthy of note.

Both the Elementary Education Act of 1899 and IDEA require medical categorization
for eligibility purposes and attribute the educational problems experienced
by children with disabilities to the child's disability and not to the
failure of the regular education system.

Medical Classification of Children with Disabilities in the U.S.

Sixty-six years after the passage of the 1899 Elementary Education (Defective
and Epileptic) Act in England, the U.S. Congress passed the first federal
law to assist in the education of children with disabilities in 1965,
P.L. 89-313. This law amended Title I of the Elementary and Secondary
Education Act (ESEA) to include the provision of financial assistance
to State operated or supported schools for "handicapped children"
(Zettel, 1977). For the purposes of eligibility, P.L. 89-313 continued
the historical tradition of medically classifying children with disabilities
in education established under English law by providing the following
definition of "handicapped children":

The term "handicapped children" means mentally retarded,
hard of hearing, deaf, speech impaired, visually handicapped, seriously
emotionally disturbed, crippled or other health impaired.... The term
also includes children with specific learning disabilities to the extent
that such children are health impaired. (Education Policy Research Institute,
1976)

These medically-based eligibility categories were maintained when P.L.
91-230 was passed in 1970, which created the Education of the Handicapped
Act. Five years later, they were incorporated into P.L. 94-142, the Education
for All Handicapped Children Act of 1975 (Zettel, 1977). The only change
made to the eligibility categories by P.L. 94-142 was the removal of the
word "crippled" and the separation of the category of children
with "specific learning disabilities" from the category of children
who were "health impaired" (Education for All Handicapped Children
Act (EAHCA), 1975).

To be eligible for special education under P.L. 94-142, therefore, children
had to be defined "as being mentally retarded, hard of hearing, deaf,
speech impaired, visually handicapped, seriously emotionally disturbed,
orthopedically impaired or as having specific learning disabilities, and
who because of those impairments need special education and related services"
(EAHCA, Sec. 121a.5(a)). According to Hocutt and Alberg (1994), these
traditional categories of disability were retained in the legislation
for three reasons:

(a) Use of categories helped generate advocacy and consequently Congressional
support for the legislation, (b) use of the categories helped Congress
and the public understand who was meant to benefit from the legislation
(i.e. children with disabilities) and who was not to benefit (i.e. poor
or underachieving children), and (c) proponents of the law feared that
if a noncategorical approach were employed, the resulting debate would
detract from the primary mission of ensuring a free, appropriate public
education for all handicapped students. (Hocutt and Alberg, 1994, p.
200)

In spite of the evolving etiology of disability in the past decade, for
the most part, these categories have undergone little change since 1975
and still provide the basis for special education eligibility in the United
States. The current categories of "autism" and "other health
impaired" were included in P.L. 94-142 under the classifications
of "seriously emotionally disturbed" and "orthopedically
impaired," respectively. In the 1990 Amendments to IDEA, a separate
category for "autism," independent of "seriously emotionally
disturbed," was created and a new category of "traumatic brain
injury" was added. Finally, in the 1997 Amendments to IDEA (P.L.
105-17), the word "seriously" was removed from the category
of "seriously emotionally disturbed." In addition, the revised
regulations added "attention deficit disorder" and "attention
deficit hyperactivity disorder" to the list of conditions that could
render a child eligible under the "other health impaired" category
(Silverstein, 1999), while stopping short of creating a whole new category
for ADD/ADHD.

Eligibility for special education and related services under current
Federal law, therefore, requires that the following conditions be met:
(a) the child in consideration must be a "child with a disability"
as defined by Section 300.7 (i.e. a child with mental retardation, hearing
impairments, speech or language impairments, visual impairments, emotional
disturbance, an orthopedic impairment, autism, traumatic brain injury,
deaf-blindness, multiple disabilities, other health impairments, or specific
learning disabilities); and (b) it must be demonstrated that the child,
by reason of one of these 12 disabilities, "needs special education
and related services" because their disability "adversely affects
their educational performance" (IDEA, 1997).

To receive their "right" to a free and appropriate public education,
therefore, children with disabilities in most states in the U.S. must
first be branded by a medical label and then must show that their disability,
a fundamental and often positive part of their identity, is the cause
of their poor educational performance (Ahearn, 1993). Labeling people
with disabilities by medical categories and attributing the problems they
experience to their disabilities is antithetical to the philosophy and
goals of the disability civil rights movement. Therefore, it is prudent
to explore the purpose behind the system of categorical eligibility for
special education and to ask why such a system was established in the
U.S. during a time of expanding rights for people with disabilities.

Purpose of Categorical Eligibility for Special Education

In the literature on the topic of categorical eligibility for special
education, the argument is frequently made that the "focus on categorical
eligibility in IDEA is understandable in view of the state of knowledge
and technology when the law was formulated in the mid-1970s" (Assessment
and Eligibility, 1994). What this argument fails to recognize, however,
is the true nature of the historical context within which P.L. 94-142
was developed. As shown in the section above, the establishment of a categorical
system of eligibility for special education was largely driven by a historical
legacy and centuries-old practice of medically classifying children with
disabilities for educational purposes.

In addition, contrary to popular belief, the categorical system of eligibility
was not simply the product of its time, an era ignorant of the social
construction of disability. P.L. 94-142 was enacted two years after the
passage of the first major piece of civil rights legislation in the United
States for people with disabilities, Section 504 of the Rehabilitation
Act of 1973. It was established during a time in our nation's history
which marked the birth of the disability civil rights movement and a corresponding
shift in the understanding of disability as a social rather than a medical
phenomenon.

According to Gill (1998), the experience of disability has been historically
viewed as a "tangible flaw located within an individual's physical
or mental constitution." This view comprises what has been commonly
referred to as the "medical model of disability." With the passage
of Section 504, however, disability rights activists and others began
articulating a "social model of disability" which "[de-emphasizes]
the significance of individual impairments (such as, paralysis, blindness
or learning limitations) in causing the problems persons with disabilities
face" (Gill, 1998, p. 1). It "[focuses], instead, on such socially
constructed barriers as exclusion, blocked access and disability prejudice
as the 'real' problems of disability" (Gill, 1998, p. 1).

According to a social model of disability, therefore, the educational
difficulties experienced by disabled children in the regular education
classroom are not necessarily caused by their individual impairments,
but might rather be the result of a poorly-developed regular education
system that is not equipped to meet the needs of a diverse student population.
Rather than acknowledge this, however, the eligibility requirements for
IDEA explicitly locate the problem within the individual disabled child.
This line of thinking is completely contrary to the social understanding
of disability that was prevalent in the 1970s and articulated in such
policies as Section 504. How, then, did it become a part of one of our
nation's most comprehensive civil rights laws guaranteeing all children
with disabilities the right to equal educational opportunity? Berkowitz
(1992) provides an explanation for this apparent contradiction.

In his article, "Disabled Policy: A Personal Postscript," Berkowitz
outlines what he considers to be "a central conflict or tension in
disability policy" between "the rhetoric of rights and the realities
of economics":

Put another way, the discovery or awarding of new rights rearranges
the distribution of resources. The redistribution of resources leads
to the disruption of existing routines and to political conflict that
must be resolved in the policy process. (Berkowitz, 1992, p. 2)

According to Berkowitz, the policy process contains several means of
muting this conflict, including the tactic of "portraying apparent
expenditures as forms of long-range investments or cost-savings"
(p. 4). This conflict between the rhetoric of rights and the realities
of economics, and the corresponding rationale of investment and cost-savings,
was apparent in the passage of P.L. 94-142.

As Zettel noted in 1977, "Although we often refer to Public Law
94-142 as being a single act, from a conceptual point of view, we can
look upon this piece of Federal legislation as actually being two acts
within one" (p.5). "First and unquestionable," Zettel writes,
"P.L. 94-142 is a rights act ... a mandate that all handicapped children
must be educated" (p. 5). Secondly, "it is a management and
finance act ... this law provides for Federal funds to help assist State
and local educational agencies in providing the special educational and
related services needed to meet the unique needs of all of their handicapped
students" (p. 6). P.L. 94-142, therefore, clearly embodies the conflict
in disability policy between the rhetoric of rights and the realities
of economics.

Also apparent in the passage of P.L. 94-142 was the corresponding rationale
of investment and cost-savings. During the congressional hearings held
prior to the introduction of P.L. 94-142 in April 1975, the Senate Subcommittee
on the Handicapped concluded that "with proper educational services,
many of these handicapped children would be able to become productive
citizens contributing to society instead of being left to remain burdens
on society" (Subcommittee on the Handicapped, 1976, p. 127).

In addition to employing a rationale of investment and cost-savings,
another typical method used in disability policy to address the conflict
between the rhetoric of rights and the realities of economics is limiting
eligibility through categorical definitions of disability (that are often
based on a medical model). In order to limit eligibility and cut costs
for Social Security disability insurance, for example, a stringent definition
of disability is applied: "the inability to engage in any substantial
gainful activity by reason of any medically determinable physical or mental
impairment." To receive the income support and health care coverage
needed, therefore, many people with disabilities have to conform to an
individual-deficit model that assigns them the stigmatizing label of being
unable to work.

A similar method of limiting eligibility and cutting costs through a
categorical definition of disability is applied under IDEA. A 1994 report
by Project Forum on assessment and eligibility in special education, in
fact, states that "one of the intended functions of a categorical
eligibility model is to regulate how services are provided so that services
and resources are directed at those who are most in need of them and to
prevent abuses" (Assessment and Eligibility, 1994, p. 10). In the
past 24 years, however, the categorical system of eligibility for special
education has done little to limit eligibility and cut costs.

According to Walker (1987), when P.L. 94-142 was passed Congress placed
a 2 percent cap on the number of children eligible to be counted for funding
purposes under the category of specific learning disability. Six years
later, a 1981 report by the Comptroller General examining the impact of
P.L. 94-142 found the following:

Congressional fears that a disproportionate share of funds might be
allocated to the learning disabilities category (the magnitude of which
is not clearly known or understood) seem to have been realized with
the lifting of the 2 percent cap on the number of learning disabled
children who can be counted for Federal funding purposes. (Disparities
Still Exist, 1981, p. v)

Today, more than 51 percent (2,676,299) of the school-age students served
under IDEA are classified in the learning disabilities category (To Assure
the Free..., 1998). This represents a 37.8 percent increase in the number
of students with learning disabilities served over the past 10 years alone
(To Assure the Free..., 1998). The attempt to restrict the eligibility
and funding for students with learning disabilities, therefore, has proven
futile.

An underlying assumption of the categorical system of eligibility is
that it is more effective in limiting eligibility than the common alternative,
a non-categorical system of eligibility. Experience with Part C of IDEA,
which authorizes services for infants and toddlers with disabilities,
has led some researchers to conclude that a non-categorical system of
eligibility for special education may actually be more effective than
a categorical system, or at least as effective, in restricting eligibility.
According to McLean, Smith, McCormick, Schakel and McEvoy (1991),

Concern has been expressed that adding a `non-categorical' option would
greatly increase the number of children eligible for preschool special
education services. However, available data on the percentage of preschool
children being served in states using a non-categorical system does
not support this conclusion" (p. 2).

In support of their argument, McLean et al. cited a 1991 Report to Congress
by the Office of Special Education Programs which showed that the percentage
of preschool children identified as having disabilities in states using
a non-categorical system of eligibility did not differ appreciably from
states using a categorical system (p. 3). They argued, in fact, that "a
review of the percentage of children from three through five years of
age identified as having disabilities in the 1991 Report to Congress shows
that many of the states using a non-categorical system have percentages
that are well below states using a categorical system" (p. 3). In
another study conducted by the Research Triangle Institute comparing the
implementation of categorical and non-categorical special education, Hocutt
and Alberg (1994) found that "the noncategorical and categorical
states served relatively the same percentages of students in the special
education program" (p. 216).

It appears, therefore, that the main purpose of establishing a system
of categorical eligibility for special education - restricting eligibility
and cutting costs - has been largely ineffective. The failure to restrict
eligibility and cut costs, however, is only one of many problems inherent
in the system of categorical eligibility for special education in the
United States. Some of the more notable problems are discussed in the
section that follows.

Problems with a System of Categorical Eligibility for Special Education

The problems and concerns associated with a system of categorical eligibility
for special education are well documented in the literature (Ahearn, 1993;
Graden, Zins, Curtis, and Cobb, 1988; Reauthorization of the Individuals...,
1994; Reynolds and Lakin, 1987; and Ysseldyke, Algozzine, and Thurlow,
1992). In 1994, the National Association of School Psychologists (NASP)
produced a report in cooperation with the National Association of State
Directors of Special Education which highlighted some of the main problems
and concerns.

One of the issues raised in the NASP report is the extent to which special
education and the assessment process, in particular, are driven by the
need to determine a disability label which is often irrelevant and completely
unrelated to a child's instructional needs:

Because current assessment practices are driven to a large extent by
categorical eligibility, professionals must use assessment measures
that demonstrate eligibility according to state criteria. Unfortunately,
much of what is required to determine categorical eligibility does not
relate directly to areas of student competence, nor does it provide
information that is useful for developing appropriate interventions
and supports. (Assessment and Eligibility, 1994, p. 11)

Ahearn (1993) concurred with this conclusion and further argued that
an assessment process geared primarily toward establishing eligibility
often serves to deflect limited resources from the more important task
of determining a disabled student's educational needs.

According to Thomas Parrish (1993), Co-Director of the Center for Special
Education Finance, "Concerns about the cost-effectiveness of assessment
practices are raised by the number of studies finding that the tests and
methods used to classify students for special education services do not
provide information that resource specialists or regular teachers report
to be of use in developing instructional programs for these students"
(p. 2). Parrish cited two separate studies which showed "that only
about 62 percent of the special education dollars at the local level went
to direct special education instructional services," while 22 percent
of the remaining funds for special education services was spent on assessment,
and 15 percent on special education program administration (Parrish, 1993,
p. 2).

A second problem with categorical eligibility identified by the NASP
report is the widespread practice of making placement and service delivery
decisions on the basis of the eligibility categories: "Eligibility
requirements not only determine how students are assessed, they also influence
whether students receive services and supports, and how these services
and supports are delivered" (Assessment and Eligibility, 1994, p.
12). According to Section 300.300(a)(3) of IDEA, the services and placement
provided to a disabled child must be based on the child's identified needs
and not on the child's disability category (Silverstein, 1999). As Judy
Heumann, the Assistant Secretary for the Office of Special Education and
Rehabilitative Services, acknowledged, however, in a 1994 policy memorandum,
"While Part B does not permit public agencies to base the specific
services provided to a student on the student's disability label, many
individuals and groups have noted that - in practice - the current emphasis
in some public agencies on categorizing students results in categorical
program and placement decision-making" (Heumann, 1994). A system
of categorical eligibility, therefore, tends to result in the placement
of students "with their own kind" so to speak (i.e. with other
children who have the same diagnostic label) even though numerous studies
have shown that there is no direct relationship between disability category
and instructional need (Assessment and Eligibility, 1994, p. 13).

A third problem with categorical eligibility for special education identified
by the NASP report is the existence of financial incentives built into
the Federal funding allocation system to categorize and label children
with disabilities. In a 1994 report entitled, "ED Can Allocate Special
Education Funds More Equitably," the Education Department's Office
of Inspector General criticized the Department's policy of basing Federal
funding allocations for special education on a State's "child count"
data. According to section 300.125 of the regulations, all States have
to submit annual data reports to the Department of Education which detail
the number of children with disabilities within each disability category.
$4.9 billion dollars of Federal special education funds are then distributed
among the States on the basis of the child count data (Section 1411(d)(1)).
"As a result of the reporting requirements," the Inspector General's
report notes, "most states currently categorize disabled students
in conjunction with the process of counting students for funding purposes"
(ED Can Allocate, p. 14).

To address this concern, a construction clause, Section 300.125(d), was
added to the "child find" provisions which states that, "Nothing
in this Act requires that children be classified by their disability so
long as each child who has a disability listed in Section 300.7 and who,
by reason of that disability, needs special education and related services
is regarded as a child with a disability under Part B of the Act."
The logic in this clause seems internally contradictory and inconsistent.
It states that children do not have to be classified by their disability
as long as they fit into a disability category outlined in Section 300.7.
Yet, the very act of placing a child into one of the disability categories
is, in and of itself, an act of classification based on disability. This
also places States using a non-categorical system of eligibility (such
as Pennsylvania, Iowa, Ohio, and American Samoa) at a distinct disadvantage
under the funding allocation formula because as the clause indicates,
each child is still required to have "a disability listed in Section
300.7." As Parrish (1993) noted, furthermore, "because the IDEA
allocation is a flat-grant formula based on the number of students identified
for special education services (up to 12%), states that are finding ways
to serve certain special need students outside of the formal special education
system are losing federal funds" (p. 2).

The conclusion reached by the Inspector General's Office (1994) was that
"these funding practices have contributed to the segregation of students
into isolated programs and have served as an incentive for over-identification
of disabled students. In effect, LEAs [local education agencies] are punished
for trying to educate students without labeling them as disabled, because
they then lose Special Education funding" (Ed Can Allocate, 1994,
p. 9).

Perhaps the most important problem with a system of categorical eligibility
for special education identified by the NASP report is the fact that it
is driven by a medical model of disability which places the blame for
the educational difficulties experienced by disabled children within the
children themselves: "Categorical eligibility requirements lead to
an emphasis in assessment on child-related deficits, often restricting
a more thorough examination of the environmental contexts that influence
learning" (Assessment and Eligibility, 1994, p. 11).

This problem was brought to the attention of the Department of Education
as early as 1978. In a report written for the Bureau of Education for
the Handicapped (BEH), Newkirk, Bloch, and Shrybman (1978) noted that
some of the disability categories in the law "exhibit characteristics
of the pathological model.... The definition[s] [are] basically oriented
toward defects of deficits in the person, rather than toward his social
role or status, or toward characteristics of the environment with which
he must cope" (p. 56). In spite of this warning, a system of categorical
eligibility was maintained which holds that eligible students for special
education are those who "by reason of" their disability "need
special education and related services," because the disability "adversely
affects their educational performance."

According to Nevin (1992), this has led to the establishment of a "fix-it
paradigm or framework" within special education. In this framework,
"fixing it typically means fixing the child.... and the `it' relates
to what is wrong (e.g., mental retardation, emotional disturbance, learning
disability) which are purportedly separate and distinct categories of
differences that are related to separate and distinct methods of fixing
or ameliorating the `it'" (Nevin, 1992, p. 14).

The existence of this "fix-it" system in special education
was acknowledged in the 1978 Newkirk et al. report to the Bureau of Education
for the Handicapped: "The educational assessment and diagnosis ...
has been broadly divided into two types of procedures: (1) those for determining
if a specific disability exists ..., and (2) those for planning intervention
or remedial strategies to aid the child in overcoming the disability"
(p. 124). The medical model nature of this "fix-it" framework
is evident, as indicated by Ahearn (1993): "A student is `diagnosed'
through the use of tests, and a `prescription' is written in the form
of an IEP" (p. 4).

According to Nevin (1992), there are very specific reasons for maintaining
this medically-based "fix-it" system including the distraction
it creates "from focusing on more comprehensive political and sociological
issues that plague the education community" (p. 14). As Nevin notes,
locating the problem within the disabled child draws attention away from
the socially-constructed barriers that children with and without disabilities
face in regular education such as the failure of the regular education
system to meet the needs of a diverse student population. In his discussion
on the implications of non-categorical special education, Lieberman (1980)
points out that special education has actually become the dumping ground
for the problems of regular education:

The BEH was originated with a very clear mandate for the handicapped.
When this mandate was given, a handicapped child was not handicapped
because he was failing in school; he was failing in school because he
was handicapped.... Not every child failing in school is handicapped,
but in many places every child failing in school becomes a candidate
for special education services and consequently is considered handicapped....
Lumping together children who fail in school with truly handicapped
children does an obvious disservice to both.... Many parents want extra
help for their child and rightfully so. This is a commentary on regular
education practices.... This is the classic case of school failure being
translated into a disorder of the central nervous system.... Special
education has been confused with being an answer to the problems of
regular education." (Lieberman, 1980, pp. 15-17)

Walker (1987) concurred with this indictment of the regular education
system when she posed the question, "Does special education serve
as a convenient institutional mechanism to sort unwanted students from
the mainstream of education?" (p. 106). As this analysis indicates,
children placed in special education are not necessarily "children
with special needs" (as they are commonly referred to), but are rather
children whose needs are not being met by the regular education system.
In many cases, it is not the child's disability that adversely affects
educational performance. It is the inflexibility of an educational system
that would rather segregate and separate than address the problems inherent
in the system. Regular education is unequipped to deal with children who
have diverse educational needs - such as children with disabilities, children
from racial/ethnic minority communities, and children who speak English
as a second language. Unfortunately, in the current system it is the children
themselves who are blamed for the existence of this problem.

There are several additional problems with a system of categorical eligibility
for special education, far too many to examine in this brief analysis.
Some of those additional problems include: the link between teacher training
programs and categorical labels; the tremendous variability in categorical
eligibility among and within States; the automatic assumption that if
a child fits into one of the disability categories then placement in special
education is the appropriate action; the large number of students who
may have very significant academic and behavioral issues but who cannot
receive the support they need because they do not fit into any of the
disability categories; the mislabeling and corresponding over representation
of children from racial and ethnic minority groups in some disability
categories; and the stigmatizing and dehumanizing effect of labeling children
with disabilities by a medical category (which often leads to lowered
teacher, peer, and personal expectations). Given the multiple problems
inherent in a system of categorical eligibility for special education,
one has to wonder why this system has been maintained for 24 years? A
brief overview of some of the current efforts to reform the system will
provide some answers to this question.

Efforts to Reform the System of Categorical Eligibility for Special Education

Over the years, there have been several attempts to change the eligibility
requirements for special education and related services. The most significant
reform effort to date occurred in February 1995, when the U.S. Department
of Education circulated a copy of its IDEA reauthorization proposal which
called for the replacement of the 12 disability categories in IDEA with
a disability definition similar to the one in Section 504 and the ADA.

According to the reauthorization proposal, a "child with a disability"
was defined as a child "who has a physical or mental impairment which
substantially limits the major life activity of learning, and who by reason
thereof requires special education" (Feds Eye Major Changes, 1995).
In the draft, the Department agreed with the assertion that a categorical
system of eligibility can "unfairly label students by medical definitions
of a disability, and can consign them to a program for their particular
disability that does not take individual abilities and needs into account"
(Debated issues, 1995). This proposal was met with substantial resistance
by some parents of children with disabilities and by organizations such
as the Learning Disabilities Association of America. In spite of this
opposition, at the beginning of August 1995, the proposal was included
in the Clinton administration's IDEA reauthorization bill, H.R. 1986 (Are
you ready, 1995). Within a matter of weeks, however, the proposal to eliminate
the disability categories and develop a non-categorical system of eligibility
was gutted by the House Committee on Economic and Educational Opportunities
(U.S. House Committee, 1995).

In 1996, the proposal was reintroduced through Senate bill S. 216, which
encouraged "states to abandon all disability labels under IDEA and
use a single, broad definition of eligibility based on a student's need
for special education" (Congress May Extend Option, 1997). However,
this effort at reform also failed to make it out of committee largely
due to the tremendous opposition on the part of many parents and professionals
involved in special education who felt that any reform efforts directed
toward the permanently authorized Part B (which guarantees FAPE, a free
appropriate public education) might jeopardize the hard-won educational
opportunities and rights for children with disabilities. As Ahearn (1993)
notes, any successful proposal for change must continue to guarantee children
with disabilities their right to a free and appropriate public education
and maintain the procedural safeguards needed to protect that right:

The challenge of eliminating the disadvantages of current procedures
for establishing eligibility while maintaining the protections of the
IDEA and Section 504 of the Rehabilitation Act of 1973 is complex. Many
of the issues involved are legal/and or fiscal in nature. For example:
Can due process rights be protected under a system that does not label
each individual student as eligible for special protections? Or, can
there be a system in which individual children's rights are protected
without categorical identification? (Ahearn, 1993, p. 6)

According to an increasing number of advocates and professionals in special
education, the answer to this question is not a system of non-categorical
eligibility (as proposed by the Department of Education). The replacement
of one medical label with a supposedly "less benign" one (such
as "developmental delay") does little to remove the stigmatizing
and dehumanizing labeling process.

Basing eligibility on a definition of disability similar to the one found
in Section 504, furthermore, still reinforces a medical model of disability
by locating the problem within the disabled child and not within the educational
environment: a "child with a disability" is one "who has
a physical or mental impairment which substantially limits the major life
activity of learning, and who by reason thereof requires special education".
The complete removal of the medical model of disability from a disabled
student's right to equal educational opportunity requires much more than
a switch from a categorical to a non-categorical system. It requires a
fundamental restructuring of the entire educational system and a dramatic
reconceptualization of that right.

A Fundamental Restructuring of the Educational System, and a Dramatic
Reconceptualization of the Right to Equal Educational Opportunity for
Students with Disabilities

After a thorough analysis of the main problems inherent in a system of
categorical eligibility, the 1994 report by the National Association of
School Psychologists came to the conclusion that student need rather than
medically-based eligibility criteria must be the basis for the delivery
of supports and services (Assessment and Eligibility, 1994). NASP called
for the development of a "comprehensive, integrated service delivery
system" that is based on the premise that "all children can
learn, and all children have a right to a free and appropriate education
without having a categorical label. The education system must be designed
to be responsive to the needs of all children, with and without disabilities"
(Assessment and Eligibility, 1994, p. 2).

According to Ahearn (1993), a system meeting these requirements is currently
in place in Pennsylvania:

The focus of the new process in Pennsylvania is a revised approach to
dealing with students who are experiencing difficulty in the regular class
program. Rather than immediately assuming that the failure to learn is
due to some defect within the student, new procedures call for a focus
on determining the student's functional ability in the classroom and the
ability of that program to maintain the student as successful. This approach
reverses the order of answering the two questions that are involved in
establishing eligibility. What is usually the first question - Is the
student disabled? - is no longer asked first. Rather, the attention is
initially focused on the second question - Does the student need special
education? If interventions can be devised and implemented by regular
teachers in regular classes so that the student can be successful in the
regular classroom, the question of disability does not need to be raised.
Regardless of whether it could be established that the student qualifies
as a student with a disability, a positive response to the question now
posed first obviates the need to consider the existence of a disability.
(Ahearn, 1993, p. 8)

In Pennsylvania, therefore, the practice of labeling children with disabilities
and blaming them for their educational problems has largely been eliminated.
Pennsylvania has focused, instead, on reforming the educational system
in order to equip teachers and administrators with the tools they need
to meet the challenge of educating a diverse student population. Children
with disabilities in Pennsylvania are not treated as "different"
and "special" simply by virtue of their disabilities, but rather
as equal partners entitled to an equal educational experience. The system
in Pennsylvania should serve as an example for the rest of the nation
that the medical model of disability, as embodied in the categorical system
of eligibility, is not compatible with a disabled student's legal and
moral right to a free and appropriate public education.

We return, then, to the question posed at the beginning of this discussion:
Do children with disabilities in the U.S. truly have a right to a free
and appropriate public education when that right is tied to the acceptance
of a stigmatizing label based on a medical model of disability? For many
children with disabilities today, IDEA represents little more than the
enshrinement and reinforcement of the medical model of disability in their
lives. These children might, in fact, agree with President Ford's prediction
that IDEA's "good intentions" were "thwarted by the many
unwise provisions it contains," such as a system of categorical eligibility.
Until the medical model of disability is divorced from a disabled child's
right to equal educational opportunity, children with disabilities will
continue to be relegated to a system of separate and unequal education
where they are defined by their medical labels. This situation must be
changed - the identity and self-worth of children with disabilities can
no longer be sacrificed in the name of curtailing costs.

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